POS1310 LONG - TERM OUTCOMES IN ADULT PATIENTS WITH SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS
Authors: E. Kiseleva, E. Koltsova, E. Volnukhin, N. Savenkova, A. Klimets, E. Rozochkina, A. Kovshik, G. Lukina
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic juvenile idiopathic arthritis (sJIA) debuts in childhood and persists throughout the patient’s lifetime. Currently there is not enough information about the course and therapeutic approaches in patients who have reached the age of 18 and moved from pediatric service to adult healthcare system. Objectives Evaluate long - term outcomes in patients with sJIA over 18 years of age. Methods Thirty - two patients with sJIA have been analyzed after their transition to adult rheumatological chain. The following parameters have been estimated: clinical manifestations, disease duration, radiological changes, medication intake, disease activity, number of arthroplasties, pregnancy, level of education. Disease activity has been assessed using a standardized DAS28 index (remission - less than 2.6, low activity - from 2.6 to 3.2, moderate activity - from 3.2 inclusive to 5.1, high activity - more than 5.1) and counting systemic manifestations. Results Among patients included in the study, there were 11 men (34.38%) and 21 women (65.62%); the average age at the time of inclusion was 23.68 (±5.93). In 13 (40.63%) patients the onset of the disease occurred before the age of 5, in 7 (21.87%) - from 6 to 10 years and in 12 (37.50%) - after 11 years. In 9 (28.13%) patients the duration of the disease was less than 10 years, in 23 (71.87%) patients – more than 11 years. The onset of the disease was accompanied by the following symptoms: fever - 28 (87.50%) patients, arthritis - 21 (65.63%), rash - 17 (53.13), arthralgia - 6 (18.75%), pericarditis - 4 (12.50%), sore throat - 4 (12.50%), lymphadenopathy - 3 (9.38%), hepatomegaly - 2 (6.25%). Among patients with arthritis 11 (52.38%) had oligoarthritis, 10 (47.62%) had polyarthritis. 2 patients (6.25%) were diagnosed with uveitis. According to the X-ray examination (Steinbrocker’s classification of radiographic changes): 5 (15.63%) patients had the I stage, 13 (40.62%) - the II stage, 4 (12.50%) - the III stage, 6 (18. 75%) - the IV stage and 4 (12.50%) had no radiological changes. Three (9.38%) were diagnosed with aseptic necrosis and these patients underwent arthroplasty. Four (12,50%) patients had pregnancy. Education: 17 (53.13%) people study at higher educational institutions. Two (6.25%) have a higher educational level. Disease activity: 24 (75%) patients are currently in low activity or disease remission, 8 (25%) are in moderate activity. Twenty (62.50%) patients receive therapy with disease - modifying antirheumatic drugs (DMARDs), 14 of them take methotrexate at an average dose of 12.68 (±3.98) mg. 6 (18.75%) patients take glucocorticoids at a dose of 1 to 8 mg per day. Non - steroidal anti - inflammatory drugs (NSAIDs) are received by 2 (6.25%) patients. Biological disease - modifying antirheumatic drugs (bDMARDs) are used by 27 (84.38%) patients, 18 (66.67%) of whom are on therapy with tocilizumab. Among the patients with low activity and disease remission: 15 out of 24 (62.50%) are treated with tocilizumab, 3 (12.50%) – with canakinumab, 3 (12.50%) – with etanercept, and 1 (4.17%) – with adalimumab; 2 (8.33%) patients don’t take bDMARDs. Conclusion The use of bDMARDs helps successfully control the disease in patients with sJIA, maintain long - term remission and improve long - term outcomes in adult patients with sJIA. Disclosure of Interests None declared